Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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A Case of Peripheral Polyneuropathy Induced by Occupational 2,5-hexanedione Exposure

2,5-헥산디온에 노출된 근로자에게서 발생한 말초 신경병증

Cho, Seong-Yong;Jang, Yong-Seok;Choi, Eun-Kyung;Kim, Jin-Seok;Yu, Jay-Young;Woo, Kuck-Hyun;Choi, Tae-Seong
조성용;장용석;최은경;김진석;유재영;우극현;최태성

  • Published : 20070300
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Abstract

Objectives: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. Methods: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. Results: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). Conclusions: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

목적: 영상음향장비 제조업체에서 2,5-헥산디온을 취급한 근로자에게서 발생한 다발성 말초 신경병증 환례를 보고하고, 동일 공정근로자들의 말초 신경기능을 조사하고자 한다. 방법: 환례에 대해 방사선학적 검사, 소변 및 혈액 검사, 신경전달속도 검사, 작업환경 측정을 하였으며, 2,5-헥산디온의 노출을 중단시킨 후 5개월 후에 다시 신경전달속도 검사를 하였다. 동일공정 근로자들의 영향평가에서는 2,5-헥산디온에 노출된 13명의 남자 근로자를 노출군으로, 해당 물질에 노출된 적이 없는 5명의 남자 근로자를 비노출군으로 선정하여 검사를 하였다. 결과: 환례의 신경전도 검사결과 양측 척골신경과 정중신경에 이상소견을 보였으며, 호전여부를 관찰하기 위하여 5개월 후 추적검사를 실시한 결과 증상 및 신경전달속도 검사결과가 호전되었다. 동일공정 근로자들의 영향평가에서 노출군의 정중 신경과 척골신경이 비노출군에 비하여 유의하게 감소되어 있었다. 감각 신경의 진폭의 경우, 노출군의 정중 신경과 비복 신경이 감소되었으며, 운동 신경 전도속도에서는 노출군의 비골신경이 유의하게 감소되어 있었다. 말단 잠복기에서는 노출군의 정중신경, 척골신경, 비골신경, 경골신경이 비노출군에 비해서 유의하게 연장되어 있었다. 결론: 환례의 증상과 신경전달속도 검사의 이상소견은 2,5-헥산디온에 의한 말초신경병증에 부합되었다. 동일공정 근로자 건강영향평가에서 신경전달속도 검사결과 노출군과 비노출군간의 유의한 차이가 있었는데, 이를 통해 2,5-헥산디온이 근로자들의 신경독성에 영향을 줄 수 있다는 것을 확인할 수가 있었다.

Keywords

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